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A small Allegheny County community, struggling to improve the lives and livelihoods of its residents, fears it is about to lose its local hospital.

No, it's not UPMC Braddock redux. This time, the hospital in question is AGH Suburban Campus in Bellevue, that borough's largest employer with about 275 full-time staff, which joined forces with West Penn Hospital in the mid-1990s and now awaits a decision by West Penn Allegheny Heath System officials on its future.

"I think anything's possible," said Bellevue Mayor George Doscher, adding that his constituents "are feeling pretty strongly, if not adamantly, against anything changing down there."

That seems unlikely.

The West Penn Allegheny system is still struggling to right itself financially and has already undergone some consolidation and restructuring between its two largest hospitals, Allegheny General and West Penn.

Gregory Burfitt, president and CEO of West Penn and Allegheny General, said the organization expected to make a decision about the Bellevue campus by month's end.

Among the options under discussion are reducing or eliminating inpatient services, which Mr. Burfitt said represents "4 percent of the activity on the campus." The hospital, licensed for 59 inpatient beds, has an average daily census "in the low 30s."

But eliminating inpatient care would have implications for the emergency department, he added, because state law requires that a full-functioning ER must have some inpatient services available. So another possibility is converting the emergency department into an urgent care center.

At the same time, Mr. Burfitt said officials were looking at expanding gynecological and obstetrical services other than delivering babies, as well as behavioral health services.

"We want to do what makes the most sense, and serves the most people, in the most appropriate way."

Not surprisingly, the uncertainty and anticipation has many in this community of 8,000 on edge, though not necessarily in opposition.

"I don't think the hospital is going away, but it will look different," said Bellevue Council President Kathy Coder. "I'm actually excited about it because I think it will be more vibrant."

Ms. Coder praised West Penn Allegheny officials, and specifically President and CEO Christopher Olivia, for meeting personally in recent weeks with Bellevue officials, going over the financials and inpatient data, and asking for their feedback.

"I understand the dilemma they're in. You have to look at the reality of what's going on with the economy and with health care," she said. "For the CEO of the health system to sit down with us for three hours, that says something."

Those efforts to reach out to the community, though, have not stopped comparisons with events in Braddock, whose only hospital was closed in January by the University of Pittsburgh Medical Center on three months' notice and without public discussion.

AGH Suburban cardiologist Dennis Gabos, who has treated patients at the Bellevue campus for 23 years, said he and others have noticed that basic services, such as urology and some orthopedics, "have been slowly undermined at Suburban for the last two years. In my view, those basic services have been withering away in a very insidious, under-the-radar fashion."

He likened it to a grocery store that starts eliminating certain food items one by one. "Obviously, what will happen is that people eventually will stop coming to that grocery store."

Dr. Gabos also believes that it would be a mistake to think that, by moving more services to Allegheny General, patients will necessarily follow. Those accustomed to a community hospital setting might be more inclined to go to Heritage Valley Sewickley campus. Also, he said, some physicians may refer patients to UPMC Passavant instead.

"Many of the community-based physicians have preferred not to go to Allegheny General because they find it more difficult to work there than at other institutions. Physicians clearly have not felt a warm reception at Allegheny General."

Mr. Burfitt, who joined West Penn Allegheny Feb. 1, disagreed. "As people get experience with Allegheny General today, I think they will walk away with a different opinion."

But the specter of change remains unsettling.

Former Bellevue Mayor Paul Cusick said a West Penn Allegheny administrator, no longer with the health system, visited about 18 months ago "and told us how great the hospital was doing - that it was thriving financially."

Because of that, he wonders, "if they're going to do what's best for the main hospital, and Suburban may become a victim."

Mr. Burfitt said the organization doesn't break out separate financial numbers for the Suburban campus because it is considered part of Allegheny General.

Said Mr. Cusick: "The only thing I would hope is that they can maintain a number of services" such as laboratories for testing, doctor's offices, physical therapy and some level of emergency care.

"That's probably the best we can hope for," he said. "But it doesn't change the fact that if I have to go to the hospital, I won't be able to go to my local hospital."